Playing politics can cost lives

After more than a decade of bipartisan support, plans for a national electronic health system are on the brink of collapse after the federal opposition vowed to axe the scheme’s budget funding and refused to commit support to enabling legislation before the Senate.

Plans to pass laws to enable the introduction of electronic individual health identifiers for almost every Australian appear certain to be postponed until after the next federal election after the Rudd government and the opposition failed to reach a compromise on how safeguards for the new scheme would operate.

Party sources from both sides of parliament have told The Australian Financial Review that differences over potential amendments to the identifier laws were unlikely to be resolved in the near term as Labor and the Coalition divert attention to drawing up election battle lines.

The emergence of politically-driven delays for the legislation has alarmed clinicians who have been waiting for e-health reform since it was first introduced as a key initiative by Australian health ministers in 1998 through the establishment of the National Health Information Management Advisory Committee.

Australian Medical Association president
Andrew Pesce
said the identifier was crucial to the success of any e-health program.

“You can’t have an e-health system without an identifier," Dr Pesce said. “I just don’t see any point in stalling – it really needs to proceed. If there are problems they should be fixed. If there are not, it should be passed."

Known as the Healthcare Identifiers Bill 2010, new laws under consideration would change the existing Medicare Act to allow for the creation of new unique health identifier numbers, which are intended to form the cornerstone of patient controlled electronic health and medical records that could be transferred between clinicians and care providers.

While most large businesses and government organisations have had electronic customer records for nearly 20 years, similar progress in health has been frustrated by the fragmented and complex nature of the sector.

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Commitments from the both sides of politics to prioritise the introduction of e-health as a means to cut down on deadly medical errors and spiralling cost blowouts have spanned five electoral terms and appeared close to fruition before the most recent federal budget.

Health Minister Nicola Roxon had been banking on the health identifier legislation being passed by July 1 so her department can start issuing the new identifier numbers.

However, delays to other key bills, including wider health reforms and the now junked emissions trading scheme have meant political attentions were diverted away from negotiations as both sides entered election mode for a poll that is expected at the end of this year.

For the most part the introduction of the e-health reforms had managed to garner bipartisan support – at least until the federal budget earlier this month when the Rudd government pledged $467 million over two years to develop e-health records.

Although the new funding was well short of the $1.6 billion that had been estimated as the cost of a national e-health and medical records rollout for Australia, health advocates have supported it as a concrete start after years of delays.

But in a surprise move the Opposition used its budget reply to vow to scrap the budget measure on the basis that the government could not be trusted to deliver such a complex scheme, based on the experience of the notoriously bungled home insulation scheme.

Opposition health spokesman Peter Dutton said late last week that the coalition wanted to see greater private sector involvement in e-health – a substantial departure from the coalition’s previous position.

Shadow treasurer Joe Hockey has also defended the decision to oppose the new funding, raising eyebrows when he suggested that doctors might only be able to cope with more traditional record keeping technology.

Speaking on ABC Radio, Mr Hockey responded to criticisms by clinician group the General Practice Network, which warned cutting e-health would consign the sector to the dark ages, by saying a lot of doctors “don’t even have computers on their desks at the moment".

“It is easy to spend a lot of money on information technology," he said. “It’s hard to spend money well. And I know, when I visit my local doctor, he still hand writes everything on a card."

The comments jar with statements made by Opposition Leader Tony Abbott who, during his time as health minister in the Howard government, accused doctors of living in the era of “parchment and quill".

Meanwhile, as political to-ing and fro-ing continues, lives hang in the balance. Analysis in a Booz & Co report on the potential benefits of a comprehensive e-health implementation, released last month, suggested a fully functional e-health system could save between 5000 and 10,000 lives by the year 2020 by reducing medical errors.